PDF Vaccine Types

The first human vaccines against viruses were based using weaker or Live, attenuated vaccines currently recommended as part of the U.S. Childhood attenuated viruses to generate immunity. The smallpox vaccine used cowpox, a Immunization Schedule include thos...

The first human vaccines against viruses were based using weaker or Live, attenuated vaccines currently recommended as part of the U.S. Childhood attenuated viruses to generate immunity. The smallpox vaccine used cowpox, a Immunization Schedule include those against measles, mumps, and rubella (via the combined MMR vaccine), varicella (chickenpox), and influenza (in the nasal spray version of poxvirus that was similar enough to smallpox to protect against it but usually the seasonal flu vaccine). In addition to live, attenuated vaccines, the immunization schedule didn’t serious illness. Rabies was the first virus attenuated in a lab to create a includes vaccines of every other major type—see the table above for a breakdown of the vaccine for humans.Vaccines are made using several different processes. They vaccine types on the recommended childhood schedule.The different vaccine types each may contain live viruses that have been attenuated (weakened or altered so as require different development techniques. Each section below addresses one of the vaccine types. not to cause illness); inactivated or killed organisms or viruses; inactivated toxins (for bacterial diseases where toxins generated by the bacteria, and not Live, Attenuated Vaccines the bacteria themselves, cause illness); or merely segments of the pathogen Attenuated vaccines can be made in several different ways. Some of the most common (this includes both subunit and conjugate vaccines). methods involve passing the disease-causing virus through a series of cell cultures or animal embryos (typically chick embryos). Using chick embryos as an example, the virus is grown in different embryos in a series. With each passage, the virus becomes better at replicating in Vaccines of this type on U.S. Recommended Childhood (ages 0-6) chick cells, but loses its ability to replicate in human cells. A virus targeted for use in a vaccine may be grown through—“passaged” through—upwards of 200 different embryos or Vaccine type Immunization Schedule cell cultures. Eventually, the attenuated virus will be unable to replicate well (or at all) in human cells, and can be used in a vaccine. All of the methods that involve passing a virus Measles, mumps, rubella (MMR combined vaccine) through a non-human host produce a version of the virus that can still be recognized by the Varicella (chickenpox) human immune system, but cannot replicate well in a human host. When the resulting vaccine virus is given to a human, it will be unable to replicate enough to cause illness, but Influenza (nasal spray) will still provoke an immune response that can protect against future infection. Live, attenuated Rotavirus One concern that must be considered is the potential for the vaccine virus to revert to a form Polio (IPV) capable of causing disease. Mutations that can occur when the vaccine virus replicates in the body may result in more a virulent strain. This is very unlikely, as the vaccine virus’s Inactivated/Killed Hepatitis A ability to replicate at all is limited; however, it is taken into consideration when developing an attenuated vaccine. It is worth noting that mutations are somewhat common with the oral Toxoid (inactivated toxin) Diphtheria, tetanus (part of DTaP combined immunization) polio vaccine (OPV), a live vaccine that is ingested instead of injected. The vaccine virus can mutate into a virulent form and result in rare cases of paralytic polio. For this reason, OPV is no longer used in the United States, and has been replaced on the Recommended Hepatitis B Childhood Immunization Schedule by the inactivated polio vaccine (IPV). Influenza (injection) Protection from a live, attenuated vaccine typically outlasts that provided by a killed or Haemophilus influenza type b (Hib) inactivated vaccine. Pertussis (part of DTaP combined immunization) Pneumococcal Killed or Inactivated Vaccines Subunit/conjugate Meningococcal One alternative to attenuated vaccines is a killed or inactivated vaccine. Vaccines of this type are created by inactivating a pathogen, typically using heat or chemicals such as formaldehyde or formalin. This destroys the pathogen’s ability to replicate, but keeps it “intact” so that the immune system can still recognize it. (“Inactivated” is generally used Vaccine type Other available vaccines rather than “killed” to refer to viral vaccines of this type, as viruses are generally not considered to be alive.) Zoster (shingles) Live, attenuated Yellow fever Because killed or inactivated pathogens can’t replicate at all, they can’t revert to a more virulent form capable of causing disease (as discussed above with live, attenuated Inactivated/Killed Rabies vaccines). However, they tend to provide a shorter length of protection than live vaccines, and are more likely to require boosters to create long-term immunity. Killed or inactivated Subunit/conjugate Human papillomavirus (HPV) vaccines on the U.S. Recommended Childhood Immunization Schedule include the inactivated polio vaccine and the seasonal influenza vaccine (in shot form). Toxoids Subunit and Conjugate Vaccines Some bacterial diseases are not directly caused by a bacterium itself, but by a toxin produced by the Both subunit and conjugate vaccines contain only pieces of the pathogens they protect against. bacterium. One example is tetanus: its symptoms are not caused by the Clostridium tetani bacterium, but by a neurotoxin it produces (tetanospasmin). Immunizations for this type of Subunit vaccines use only part of a target pathogen to provoke a response from the immune pathogen can be made by inactivating the toxin that causes disease symptoms. As with organisms system. This may be done by isolating a specific protein from a pathogen and presenting it as an or viruses used in killed or inactivated vaccines, this can be done via treatment with a chemical such antigen on its own. The acellular pertussis vaccine and influenza vaccine (in shot form) are as formalin, or by using heat or other methods. examples of subunit vaccines. Immunizations created using inactivated toxins are called toxoids. Toxoids can actually be considered killed or inactivated vaccines, but are sometimes given their own category to highlight Another type of subunit vaccine can be created via genetic engineering. A gene coding for a the fact that they contain an inactivated toxin, and not an inactivated form of bacteria. vaccine protein is inserted into another virus, or into producer cells in culture. When the carrier Toxoid immunizations on the U.S. Recommended Childhood Immunization schedule include the virus reproduces, or when the producer cell metabolizes, the vaccine protein is also created. The tetanus and diphtheria immunizations, which are available in a combined form. end result of this approach is a recombinant vaccine: the immune system will recognize the expressed protein and provide future protection against the target virus. The Hepatitis B vaccine currently used in the United States is a recombinant vaccine. Another vaccine made using genetic engineering is the human papillomavirus (HPV) vaccine. Two types of HPV vaccine are available—one provides protection against two strains of HPV, the other four—but both are made in the same way: for each strain, a single viral protein is isolated. When these proteins are expressed, virus-like particles (VLPs) are created. These VLPs contain no genetic material from the viruses and can’t cause illness, but prompt an immune response that provides future protection against HPV. Conjugate vaccines are somewhat similar to recombinant vaccines: they’re made using a combination of two different components. Conjugate vaccines, however, are made using pieces from the coats of bacteria. These coats are chemically linked to a carrier protein, and the combination is used as a vaccine. Conjugate vaccines are used to create a more powerful, combined immune response: typically the “piece” of bacteria being presented would not generate a strong immune response on its own, while the carrier protein would. The piece of bacteria can’t cause illness, but combined with a carrier protein, it can generate immunity against future infection. The vaccines currently in use for children against pneumococcal bacterial infections are made using this technique. Maurice Hilleman and colleagues developed an attenuated measles vaccine by passaging John Enders’s measles virus strain over 80 times through different cell types. The resulting vaccine, Rubeovax, was given with a dose of gamma globulin antibodies to reduce reactions (mainly fever and rash). The FDA licensed Merck’s Recombivax HB. This hepatitis B vaccine was the first human vaccine produced by recombinant DNA methods. A challenge in creating the vaccine involved avoiding the use of human blood products, as did Maurice Hilleman’s first hepatitis B vaccine. Therefore, Merck used an enzyme to remove the virus’s surface protein (HBsAg, the Australia antigen). Researchers inserted the code for the antigen into yeast cells, which produced more of the surface protein. The yeast-derived surface protein produced immunity to the hepatitis B virus. Expanded Program on Immunization Achieve 95% Fully Immunized Child Coverage. 1. INTRODUCTION: A. Rationale: D. Program Strategies: The Expanded Program on Immunization (EPI) was established in 1976 to ensure that 1. Conduct of routine immunizations for infants/children/women through infants/children and mothers have access to routinely recommended Reaching Every Purok Strategy. infant/childhood vaccines. Six vaccine-preventable diseases were initially included in  The Reaching Every Purok Strategy is an innovation of the Reaching every the EPI: tuberculosis, poliomyelitis, diphtheria, tetanus, pertussis and measles. Barangay. Vaccines under the EPI are BCG birth dose, Hepatitis B birth dose, Oral Poliovirus 2. Supplemental immunization Activities (SIA) Vaccine, Pentavalent Vaccine, Measles Containing Vaccines (Antimeasles Vaccine,  Supplemental immunization activities are conducted to reach children who Measles, Mumps, Rubella) and Tetanus Toxoid. In 2014, Pneumococcal Conjugate have not been vaccinated or have not developed enough immunity after Vaccine 13 was included in the routine immunization of EPI. previous vaccinations. 3. Vaccine-Preventable Disease Surveillance This 2016, the Expanded Program on Immunization will transition to become the  Surveillance is conducted for all vaccine-preventable diseases most especially National Immunization Program. It will include immunizations of other populations for measles cases and indigenous wild poliovirus. such as senior citizen immunization, school-age immunization, and adolescent immunizations. Seven (7) Childhood B. Program Goals: Immunizable Diseases Tuberculosis ( Primary Complex if Over-all Goal: To reduce the morbidity and mortality among children against the most less than 3 years old ) common vaccine-preventable diseases. Diphteria Pertussis Specific Goal: Neonatal Tetanus Poliomyelitis 1. To immunize all infants/children against the most common vaccine- Hepatitis B preventable diseases; Measles 2. To sustain polio-free status of the Philippines; 3. To eliminate measles infection; Concept and Importance of Vaccination Immunization – is the process by 4. To eliminate maternal and neonatal tetanus; which vaccines are introduced into the body before infection sets in. 5. To control diphtheria, pertussis, hepatitis b and German Measles; Vaccines are administered to introduced immunity thereby causing the recipient’s 6. To prevent extra pulmonary tuberculosis among children. immune system to react to the vaccine that produces antibodies to fight infection. Vaccinations promote health and protect children from disease – C. Program Target: causing agents. Infants and newborn need to be vaccinated at an early age since they belong to vulnerable age group.  The following are NOT contraindication. Infants with these conditions General Principles in Vaccinating Children SHOULD be immunized: It is safe and immunologically effective to administer all EPI Allergy or asthma ( except if there is a known allergy to a specific component of vaccines on the same day at different sites of the body. vaccine mentioned above ) The vaccination schedule should not be restarted from the beginning Minor respiratory tract infection even if the interval between doses exceeded the recommended interval Diarrhea by months or year. Giving doses of a vaccine at less than the recommended Temp. below 38.5 C 4 weeks interval may lessen the antibody response. Lengthening the interval Family history of adverse reaction following immunization between doses of vaccines leads to higher antibody levels. No extra doses must Family history of convulsions, seizures be given to children who missed a dose of DPT/HB/OPV. The vaccination Known or suspected HIV infection with no signs and symptoms of must be continued as if no time had elapsed between doses. Do not give more AIDS than one dose of the same vaccine to a child in one session. Give doses of the same Child being breastfed vaccine at the correct intervals. Strictly follow the principle of never, ever Chronic illness such as diseases of heart, lung, kidney or liver reconstituting the freeze dried vaccine in anything other than the diluent supplied Stable neurological condition such as cerebral palsy or with them. If you are giving more than onevaccine, do not use the same syringe Down’s Syndrome and do not use the same arm or leg for more than one injection. Premature or low birthweight Contraindication to Immunization (vaccination should not be postponed ) Anaphylaxis or severe hypersensitivity reaction to a previous dose of vaccine is an Recent or imminent surgery absolute contraindication to subsequent doses of vaccine Malnutrition Person with a known allergy to a vaccine component should not be vaccinated. History of jaundice at birth DPT2 or DPT3 is not given to a child who has convulsions or shock within 3 days after DPT1. Vaccines containing the whole cell pertussis component should not be given EPI Routine Schedule to a children with an evolving neurological disease. Do not give live vaccines like BCG Every Wednesday is designated as immunization day and is adopted in all part to a individuals who are immunosuppressed due to malignant disease ( child with of the country. AIDS) , going therapy with immunosuppressive agents or radiation. A child with a sign and symptoms of severe dehydration FIC “Fully Immunized Child” when a child receives one dose of BCG, 3 Fever of 38.5 C and above doses of OPV, 3 doses of DPT, 3 doses of HepB and one dose of measles before a child’s first birthday. OPV ( ORAL POLIO VACCINE )  ANNOTATIONS BACILLE CALMETTE GUERIN (BCG) Given intradermally (ID) The dose of BCG is 0.05 ml for children < 12 months and 0.1 ml for children ≥ 12 months Given at the earliest possible age after birth preferably within the first 2 months of life For healthy infants and children > 2 months who are not given BCG at birth, PPD prior to BCG vaccination is not necessary. However, PPD is recommended prior to BCG vaccination if any of the following is present: o Congenital TB o History of close contact to known or suspected infectious cases o Clinical findings suggestive of TB and/or chest x-ray suggestive of TB In the presence of any of these conditions, an induration of 5 mm is considered positive and BCG is no longer recommended DIPHTHERIA, TETANUS, PERTUSSIS VACCINE (DTP) Given intramuscularly (IM) Given at a minimum age of 6 weeks. The primary series consists of 3 doses with a minimum interval of 4 weeks Booster series consists of 3 doses until adolescence with the following schedule: o 12-18 months (DTP) o 4-6 years (DTP) o 9-18 years (Td/Tdap) Ideally, the minimum interval between booster doses should be at least 4 years Full-dose DTP should preferably be used only until age 7 years, but package inserts should be consulted for maximum age indications of specific products HAEMOPHILUS INFLUENZAE TYPE B CONJUGATE VACCINE Given intramuscularly (IM) Given as a 3-dose primary series with a minimum age of 6 weeks and a minimum interval of 4 weeks A booster dose is given between age 12-15 months with an interval of 6 months from the third dose Refer to Vaccines for Special Groups for Hib recommendation in high risk children HEPATITIS A VACCINE (HAV) Inactivated Hepatitis A Vaccine Given intramuscularly (IM) Minimum age: 12 months 2 dose series: minimum interval between first and second dose is 6 months Live attenuated Hepatitis A Vaccine Given subcutaneously (SC) Minimum age: 18 months Given as single dose HEPATITIS B VACCINE (HBV) Given intramuscularly (IM) Administer the first dose of monovalent HBV to all newborns ≥2kgs within 24 hours of life A second dose is given 1-2 months after the birth dose The final dose is administered not earlier than 24 weeks of age Another dose is needed if the last dose was given at age